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| The draft Human Transplantation Bill would create a "soft opt out" system, whereby anyone not specifically opting-out of a new organ donor register will have presumed to have "opted-in". (Pic : The Telegraph) |
Following on from my post last year on the Organ Donation white paper, Health Minister
Lesley Griffiths (Lab, Wrexham) has launched what is likely to be one
of the most controversial moves the Assembly has made since
devolution.
The Draft Human Transplantation Bill will introduce a soft opt-out system for organ donation in Wales. If the final bill is passed, it'll come into effect in 2015.
How will the proposed "opt-out" system work?
There'll be a separate organ donation register for Wales, and will list whether a person has opted to donate or not to donate.
Consent will still be asked from the close families (dubbed a "qualifying relationship") of the deceased before any donation, and they can still object. The difference is those who have neither opted-in or opted-out will be presumed to have opted-in.
The Welsh Government will be legally obliged to promote transplantation (as currently) and explain the opt-out system fully to the public.
In fact, in the Bill, it'll become a criminal offence - punishable by up to 3 years in prison - to transplant organs without consent, or use them for "a purpose that is not a qualifying purpose".
I presume "not qualifying purpose" would include anatomical dissection, display or other forms of retention.
Who would be subject to the law?
The Draft Human Transplantation Bill will introduce a soft opt-out system for organ donation in Wales. If the final bill is passed, it'll come into effect in 2015.
How will the proposed "opt-out" system work?
There'll be a separate organ donation register for Wales, and will list whether a person has opted to donate or not to donate.
Consent will still be asked from the close families (dubbed a "qualifying relationship") of the deceased before any donation, and they can still object. The difference is those who have neither opted-in or opted-out will be presumed to have opted-in.
The Welsh Government will be legally obliged to promote transplantation (as currently) and explain the opt-out system fully to the public.
In fact, in the Bill, it'll become a criminal offence - punishable by up to 3 years in prison - to transplant organs without consent, or use them for "a purpose that is not a qualifying purpose".
I presume "not qualifying purpose" would include anatomical dissection, display or other forms of retention.
Who would be subject to the law?
- People over the age of 18
- Who have "capacity" to understand the procedure (it exempts those with learning disabilities for example)
- Who have lived in Wales for more than 6 months and die in Wales
For those under the age of 18, eligible to be a donor, their own wishes will be the only consideration. They'll be contacted by the Welsh NHS in the months leading to their 18th birthday to tell them of the new arrangements.
What are the potential benefits and drawbacks?
The explanatory memorandum lists that the new system will cost around £5million to set up, payable by the Welsh Government.
However, it also estimates that a single extra donor a year has a "net present value" of £5million (what I presume includes increases in quality of life, savings in dialysis treatment for kidney patients etc.). If the stated aim of 15 extra donors a year is met, then it's listed it could be worth £150million. An extra 25 donors would be worth £254million. There's a more detailed analysis in the memorandum if you are interested.
What's likely to be the most contentious issue surrounds whether organ donation is an altruistic "gift", rather than something the state presumes you want to do upon death because it's a "good thing". If there's no increase in organ donation, or if "compulsion" encourages people to opt-out, then it could prove self-defeating, and harm Wales' pretty decent record in organ donation.
That issue....
Yes, in the draft bill, any donated organ in Wales will be available to anyone in the UK as existing. The relevant part of the draft bill is section 15 (1)(b) which amends the Human Tissues Act 2004.
You can certainly argue that - as Wales could be about to put several hundred thousand extra potential donors on the register - England, Scotland and Northern Ireland have moral obligation to follow suit to benefit from any extra "Welsh" organs.
But....
As I said in my previous post, you shouldn't try to limit the "pool" for potential organ donors. I argued that ideally there would be a pan-EU or pan-European organ donor scheme. Just because somebody is Welsh, it doesn't mean they'll always be able to find a compatible donor within Wales. Organs move both ways across borders, and if you're in the situation of needing one, I don't think you'll care where it comes from – you'll just be thankful you have a chance of a semblance of a normal life.
There'll be plenty of non-Welsh incomers who'll be subject to this law.
Organ transplantation should always be judged on the basis of need. If there's a more needy Welsh person, they should get it - just as if there were a more needy Scot , Irish, German, Pole or even - God forbid - English.
Thanks for that, I had wondered about our organs being taken across the border.
ReplyDeleteWhilst I would encourage a reciprocal agreement I don't want to see people in Wales having to wait any longer than neccesary because someone in England has been prioritised. And because their population is 17 times the size of ours you can guarantee that this will happen.
And before anyone says this isn't humane then please remember that we're the ones who are going to be farmed for our organs. It's bad enough that Westminster owns everything else in Wales, now they'll own everything inside of us too.
I carry a donor card and I give blood. But unless something is done to prioritise us then I will opt out.
WNB - Organs are always transplanted on basis of clinical need. That should be the only concern.
ReplyDelete"Organ farming"/"Organ harvesting" is very emotive, but it isn't true, is it? That implies organs taken willy-nilly from every single body and "shipped away" whether they are needed or not. That won't happen, and it would be illegal.
If there were two people - one Welsh, the other English - with exactly the same clinical need for a transplant, and with exactly the same compatiblity, I would expect the Welsh patient to get the organ from any Welsh doner, and they probably would because they are closer.
However, if the English patient needed it more based on clinical evidence - they should receive it. Likewise, if the roles were reversed, and the Welsh patient were more in need of an English donated organ, I would expect the Welsh patient to get it.
Now, we could prioritise, but then the English, Scots & Irish would be well within their rights to follow suit. As I said, you can argue that morally they would be obliged to follow Wales' lead on this to "benefit". That means potentially 17 times fewer organs available to Welsh patients (if they were compatible). That's why I would prefer some sort of pan-Europe organ donation system.
If there were two people - one Welsh, the other English - with exactly the same clinical need for a transplant, and with exactly the same compatiblity, I would expect the Welsh patient to get the organ from any Welsh doner, and they probably would because they are closer.
ReplyDeleteReally? With our roads? With our transport network beinga classic example of all roads lead to Rome?
I want legislation in place to prevent them farming our organs. I use the term farming because that is what will happen.
As I understand it the decision about who recieves a donated organ is made in Bristol, and it is a widely known 'secret' that English patients are almost always given preference. This is yet another example of Wales being expoloited to benefit England, with our feeble assembly helping them along.
ReplyDeleteWNB - Good point on the transport issues, but "organ farming" is hyperbole. Organs are only donated when there is a compatible match, the donor has to undergo testing to ensure this. "Farming" implies that organs are seen as a resource and taken, probably "stored", without regard for compatibility - it doesn't work like that. In fact, doing so would be incredibly dangerous for the receiving patient.
ReplyDeleteBlood donations would probably fit the term "farming" better.
Anon 23:49 - It might well be the case that the Transplant Unit is based in Bristol, but for English patients to be given priority would mean Welsh, Scottish and NI doctors being complicit in underplaying the needs of their own patients on the waiting list. The decision is decided by computer programme and clinicians, which you can read about here. It's a nice conspiracy, but I'd want to see more evidence, personally. That would be Third Reich levels of human rights abuses. It's a pretty serious allegation.
"However, it also estimates that a single extra donor a year has a "net present value" of £5million (what I presume includes increases in quality of life, savings in dialysis treatment for kidney patients etc.). If the stated aim of 15 extra donors a year is met, then it's listed it could be worth £150million. An extra 25 donors would be worth £254million. There's a more detailed analysis in the memorandum if you are interested."
ReplyDeleteBecause of the Barnett funding the NHS in Wales is already disadvantaged.
If organs are 'exported' across the border, greater savings will accrue proportionately to the NHS in England, or elsewhere, if the Act has the effect of increasing the number of available donors in Wales compared to the other nations within the UK.
I don't carry a donor card at present, and possibly because of my age, there might not be a great demand for my organs. Based on what I read here, I'd be tempted to opt out for a number of reasons, some of which have been discussed by others.
I firmly believe it should be based on 'Opt Out'. ie you are automatically a donor unless you state otherwise.
ReplyDeleteI also firmly believe that those who opt out should be denied access to organs should they subsequently require them at a later date.